3S7 



Memphis, Term. — the fomites which should have developed around all the 

 imported cases of yellow fever have been powerless to bring about its pro- 

 pagation. The only point, therefore, which remained to be proved was the 

 fact that fomites which might be considered of the worst kind should 

 likewise fail to do so even within the regular yellow fever zone, and that the 

 very men who had been exposed with impunity to their action, would 

 thereafter take the infection through the bite of a contaminated mosquito ; 

 all of which the experimenters have demonstrated to perfection. 



That not only fomites, but anything that might be considered as a 

 possible receptacle for live mosquitoes, of the infectious kind, should 

 be dealt with in a manner that would ensure the destruction of those insects 

 is a self-evident corollary of the mosquito theory. Precautions should be 

 taken even against the importation of dry eggs of the Culex mosquito into 

 places where that insect is not usually found, lest a brood of those insects 

 should develop during the summer season, thereby greatly increasing the 

 difficulty of controlling the propagation of the disease if a case of yellow 

 fever were accidently introduced. 



My objection to some of the conclusions specified in the "additional 

 note" 2 ) refers merely to their exclusiveness and to the hard and fast 

 rules which have been set down without sufficient evidence in their sup- 

 port. I have elsewhere alluded to these objections as referring to matters 

 of minor importance, and so they appear to be when compared to the all- 

 important facts for which we are indebted to Drs. Reed, Carroll and 

 Agramonte. From a sanitary point of view, however, they require to be 

 looked into. If it be admitted that after the third day of an attack of 

 yellow fever mosquitoes can no longer be contaminated from the patient, the 

 inference must be that after that period it is quite superfluous to keep 

 mosquitoes away from the patient, and if it were true that the contaminated 

 mosquito can never transmit the infection until twelve or more days have 

 elapsed since its initial contamination, non-immunes might visit with 

 impunity, during their illness, the first cases that occur in a locality 

 previously free from infected mosquitoes. I have, indeed, positive evidence 

 to show that, in the summer season at least, those rules do not always hold 

 true. A fresh mosquito was applied on August 13, 1883, to a hemogastric 

 case of yellow fever whose attack had set in on the 8th; two days later, on 

 the 15th, the same insect was applied to a second case of hemogastric yellow 

 fever attacked on the 10th ; finally, on the 17th, the insect was applied to 

 a non-immune whose isolation from other sources of infection had been 

 perfectly satisfactory ; nine days later, on the 26th, this person was taken 

 sick with a mild, but well-characterized attack of yellow f ver, and 

 subsequently resided over ten years in Havana without ever experiencing 

 any illness which could possibly be referred to the yellow lever infection. 



2) Jour. Am. Med. Assn., Feb. 16, p. 431. 



